This project is a feasibility clinical study of the upper extremity Networked Neuroprosthetic (NNP) System to demonstrate efficacy in providing grasp and reach for individuals with cervical level spinal cord injury. The NNP System will electrically stimulate paralyzed muscles in a coordinated fashion to provide grasp and release, forearm pronation, elbow extension, and shoulder/trunk stabilization. The stimulated patterns will be controlled by each subject through activation of their voluntary musculature, as recorded through implanted myoelectric recording electrodes. Subject performance will be assessed through measures of impairment, activities, and participation, with a focus on the ability to perform activities of daily living more independently and on the rate of daily home use. We hypothesize that daily usage will be improved due to the fully implantable nature of the NNP System and that every subject will improve in their functional ability, regardless of their startin function level, due to the modular and customizable nature of the NNP System. PUBLIC HEALTH RELEVANCE: This project is designed to develop and evaluate an advanced, fully-implantable hand neuroprosthesis for individuals with spinal cord injury. The study is relevant to individuals with cervical level spinal cord injury because it provides them with the ability to use their hand and arm more independently.